Guns n’ Noses: Endoscopic Removal of an Air-Gun Pellet Retained in the Frontal Sinus

Endoscopic endonasal retrieval of air gun pellet retained in the frontal sinus: A case report

“…To our knowledge, this is the only other reported case of ESS usage to retrieve a retained air gun pellet in the frontal sinus [12] . Based on our experience with this patient and similar literature, ESS should be considered a treatment option for patients with retained foreign objects in the frontal sinus.…”

“…In one retrospective study, 15 % of retained metallic objects were found in the frontal sinus in head trauma patients [2] . The literature reports a variety of objects that have been retained in the frontal sinus, including glass [4] , a silicone tube [15] , and air gun pellets [12] . Reported side effects of retained foreign body in the paranasal sinuses include abscess formation, lead poisoning, and, in rare cases, meningitis [5] .…”

“…However, treatment with endoscopic approaches has become more feasible due to advances in technology, surgeons' skills, and understanding of the endoscopic sinonasal anatomy, which allows for successful, less invasive surgeries [16] . Moreover, it provides a cosmetic advantage due to a lesser chance of facial scarring [12] . Guidelines for retrieving foreign objects have not yet been set in stone; however, a proposed guideline suggests endoscopic intervention when possible if there is a risk of infection or persistent CSF leakage [2] .…”

“…A similar case reported a 16-year-old male presenting with an air gun pellet in the frontal sinus. The pellet was successfully removed using an endoscopic procedure, and there was no evidence of CSF leakage [12] . The endoscopic approach used in this case was the Draf IIa approach, while our case used the modified Lothrop or Draf III approach.…”

“…In this article, we present the case of an 18-year-old who underwent endoscopic sinus surgery (ESS) in an academic hospital after presenting with an air gun pellet in his frontal sinus. To the authors' knowledge, this is the second article reporting the usage of ESS to remove an air gun pellet in the frontal sinus [12] . This case report is reported in line with the SCARE criteria [13] .…”